title: Epidemiology and outcome of sepsis syndromes in Italian ICUs: a muticentre, observational cohort study in the region of Piedmont.
abstract: BACKGROUND
  Sepsis is an important cause of mortality and morbidity in the intensive care unit (ICU). We performed a study to describe the epidemiology of sepsis syndromes in patients admitted to ICUs of the Piedmont region.
  
  
  METHODS
  In this prospective, multicentre, observational study, all 3902 patients admitted to a network of 24 ICUs from 17 hospitals during a 180 day period (April 3-September 29, 2006) were included. Patients were followed from the first day of admission until death or ICU discharge.
  
  
  RESULTS
  The incidence of sepsis during the ICU stay was 11.4% (N.=446), corresponding to an incidence of 25 cases/100,000 inhabitants/year; 141 (31.6%) patients had only sepsis, 160 patients had severe sepsis (35.9%) and 145 patients (32.5%) had septic shock In 227 patients (50.9%), sepsis was observed within 48 hours after admission to the ICU, and 219 patients (49.1%) developed ICU-acquired sepsis. The main sources of infection were the lungs, abdomen, and urinary tract. ICU mortality was higher (41.3 vs. 17.3%, P<0.0001) and the median ICU length of stay longer (15 vs. 2 days, P<0.0001) in patients with sepsis than in those without sepsis. The mortality rate increased with the severity of sepsis. ICU-acquired sepsis was associated with higher ICU mortality rates than sepsis occurring within 48 hours of ICU admission (49.8 vs. 33.0%, P<0.0001).
  
  
  CONCLUSIONS
  Sepsis is a common occurrence in critically ill patients. Our data underscore the regional variability in the epidemiology and outcome of sepsis syndromes and may be useful to guide appropriate resource allocation.
authors.affiliation: Department of Anesthesiology and Intensive Care, Friedrich-Schiller-University, Jena, Germany - yasser.sakr@med.uni-jena.de.
authors.forename: Y
authors.initials: Y
authors.lastname: Sakr
authors.forename: C
authors.initials: C
authors.lastname: Elia
authors.forename: L
authors.initials: L
authors.lastname: Mascia
authors.forename: B
authors.initials: B
authors.lastname: Barberis
authors.forename: S
authors.initials: S
authors.lastname: Cardellino
authors.forename: S
authors.initials: S
authors.lastname: Livigni
authors.forename: G
authors.initials: G
authors.lastname: Fiore
authors.forename: C
authors.initials: C
authors.lastname: Filippini
authors.forename: V M
authors.initials: VM
authors.lastname: Ranieri
mesh_terms: D000368:Aged; D015331:Cohort Studies; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D007558:Italy / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D018805:Sepsis / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy*; D016019:Survival Analysis; D016896:Treatment Outcome